Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a type of chest pain or
discomfort that happens when there is not enough blood flow to the heart. Angina is a symptom of heart disease that slows blood flow to the heart. This is often a result of narrowed blood
vessels, usually caused by hardening of the arteries (atherosclerosis).
can be dangerous. So it is important to pay attention to your symptoms, know what
is typical for you, learn how to control it, and understand when you need to
Symptoms of angina include chest pain or pressure, or a strange feeling in the chest. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Other symptoms of angina include shortness of breath, nausea or vomiting, lightheadedness or sudden weakness, or a fast or irregular heartbeat.
Know what your angina feels like and what is typical for you so you know when to call for help.
Do not wait if you think you are having a heart attack. Getting help fast can save your life. Even if you're not sure it's a heart attack, have it checked out.
Stable angina has a typical
pattern. You can likely predict when it will happen. It happens when your heart is working harder and needs more oxygen,
such as during exercise. It also may occur during exposure to cold or during times of
emotional stress. The pain goes away when you rest or take nitroglycerin. It may
continue without much change for years.
Unstable angina is unexpected. It is a change in your usual pattern of stable angina. It happens when blood flow to the heart is suddenly slowed by narrowed vessels or small blood clots that form in the coronary arteries. Unstable angina is a warning sign
that a heart attack may soon occur. It is an emergency. It may happen at rest or with light activity. It does not go away with rest or nitroglycerin.
Angina caused by coronary artery spasms
Less common types of angina are caused by coronary artery spasms. This angina happens when a coronary artery suddenly contracts (spasms), reducing
oxygen-rich blood flow to the heart. If severe, a spasm can block blood flow
and cause a heart attack. Most people who have these spasms have coronary artery disease, though they don't always have plaque in their arteries. Cocaine can cause coronary
artery spasm and heart attack, but in most cases it is not known what triggers
Variant angina, also called Prinzmetal's
angina or vasospastic angina, is also caused by coronary artery spasm. But
it has a distinctive pattern. It usually occurs when you are at rest, and
there is no clear cause. It occurs more often at night, in the early morning
hours, or at the same time of the day. The spasm often occurs where plaque has narrowed the
coronary artery, but it can also occur in healthy
coronary arteries. Variant angina episodes typically last 2 to 5 minutes and
quickly subside with nitroglycerin.
Most people who have stable angina can
control their symptoms by taking medicines as prescribed and nitroglycerin
For tips on managing angina see:
Other health problems, such as fever or infection, anemia, or other heart problems, can make your angina symptoms worse. They may also cause unstable angina.
Angina may get worse when another condition:
In either case, there is an imbalance between the amount of oxygen
that your heart needs and the amount that it receives through the blood supply
from your coronary arteries. If your heart can't get enough oxygen, your
symptoms of stable angina may get worse.
April 4, 2011
E. Gregory Thompson, MD - Internal Medicine & John M. Miller, MD, FACC - Cardiology, Electrophysiology
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